NPIMap

Organization Active NPI

South East Alaska Regional Health Consortium

  • General Practice Dentistry
  • Juneau, AK
National Provider Identifier
1881730802
Registry record updated Apr 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
70206 Issued in AK
Legal business name
SOUTH EAST ALASKA REGIONAL HEALTH CONSORTIUM
Practice address
3245 Hospital Dr
Juneau, AK 99801-7809
Phone
(907) 463-4041
Fax
(907) 463-4032
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Daniel Harris
Title
Sr. VP / Cfo
Phone
(907) 463-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 70206 AK Primary

Addresses

Primary practice location

3245 Hospital Dr
Juneau, AK 99801-7809

Mailing address

3245 Hospital Dr
Juneau, AK 99801-7809
Phone (907) 463-4041

Other identifiers 1

IdentifierTypeStateIssuer
1003866MedicaidAK

Other names 1

  • SEARHC Juneau Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mark Peterson88 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617667200000",
    "number": "1881730802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017809",
            "telephone_number": "907-463-4041",
            "fax_number": "907-463-4032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 HOSPITAL DR",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017809",
            "telephone_number": "907-463-4041",
            "fax_number": "907-463-4032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH EAST ALASKA REGIONAL HEALTH CONSORTIUM",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2021-04-06",
        "certification_date": "2021-04-06",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "SR. VP / CFO",
        "authorized_official_telephone_number": "907-463-4000"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "70206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003866",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SEARHC Juneau Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Juneau, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.